Workers’ Compensation/ Work Place Accidents

One of the most common misconceptions is that if you pursue workers’ compensation or if you hire an attorney, you are suing your employer. In reality, however, Georgia law actually prohibits you from suing your employer for injuries you sustained on the job. This is true even if it was your employer’s fault. If you have been injured on the job, Georgia law states that the only avenue for recovery is by filing a claim for workers’ compensation benefits with one exception – you may have an additional claim against an independent third party who is responsible for your injuries. 

Under Georgia law, if an employer has three or more employees, the employer must carry workers’ compensation insurance or face a penalty and potential personal liability. Under the employer’s insurance policy, an injured worker may be entitled to certain benefits if he or she is able to prove certain aspects of the claim. The following is a list of what they may pay for/what you may be able to collect, all of which will depend on whether you can prove certain elements of your claim and whether you and the insurance company appropriately follow certain rules and procedures. 

Fortunately, The Barionnette & Eisenhower Law Firm LLC has plenty of experience handling workers’ compensation claims and is prepared to answer any questions you may have.

Insurance companies are in the business of making money and holding on to it, and they are constantly looking for any reason they can to deny or reject your claim to avoid paying you money. Sometimes the insurance company may deny an entire claim outright from the beginning. Other times, the insurance company may accept a claim in whole or in part and later decide to deny/reject the entire claim or just part of the claim. Throughout her years of practice, Jessica has become familiar with these tactics and has observed that the following are some of the most common reasons to reject claim or deny benefits in whole or in part:

This ranges from claiming that the Employee was never injured in the first place, the Employee had the injury prior to working for the Employer, or the Employee sustained the injury while employed with the Employer but not while actually performing work for the Employer (i.e. falling down the stairs of your home on your way to work).

This argument is raised most frequently when a general contractor is the alleged employer. The insurance company may argue that the general contractor hired a subcontractor, who then hired the Employee and therefore, the subcontractor’s insurance is on the hook. However, Georgia law provides for what is called a statutory employer. Essentially, the general (or principal) contractor can potentially be held liable for compensation to an injured employee while employed by a subcontractor that did not carry insurance. This can be a very tricky situation and calls for the assistance of an experienced workers’ compensation attorney.

Only employees can receive benefits under a workers’ compensation plan. Make sure to consult with an attorney, as there may be a very fine line between whether someone qualifies as an employee or an independent contractor. 

This can be tricky because there are several different statutes of limitations under Georgia workers’ compensation laws. The general rule is that the Employee must file a claim within one year of the date of injury. However, this time frame may be extended if the Employee received medical treatment, weekly checks, or both from the insurance company. In that case, the Employee has one year from the date of last remedial medical treatment furnished by the Insurer or two years from the last payment of weekly income benefits to file a claim.

Sometimes these arguments and defenses have merit, and other times they are asserted by the insurance company just to try to get out of paying out on a claim. Unfortunately, they often take advantage of people who represent themselves and ultimately get away with not paying benefits based on a bogus argument or defense. That is why it is so important to consult with an experienced workers’ compensation attorney.